Bladder Leakage in Women Who Exercise
Urine leakage (incontinence) is a common problem in women who exercise.
Leakage becomes more likely with high impact activities such as trampolining and jumping, or with sports involving large forces such as weight lifting.
Unfortunately, according to this study, women who leak are more likely to stop exercising. Approximately, 23% of incontinent women do not exercise because of their incontinence, and 60% of women with severe incontinence are likely to be underactive.
How does Leakage Happen?
Leaking occurs when pressure is poorly transmitted through the body. When pressure in the abdomen increases, the pelvic floor muscles and soft tissues below the bladder must respond to counteract the bearing-down force or the waterpipe will give way.
This pressure can come from weights applied during a movement, from impact when landing on the ground, or from bracing of the abdominal muscles.
Leakage in Women Who Lift Heavy
Urine leakage in Olympic weightlifting is common due to the high loads experienced in this sport. Common weightlifting techniques such as bracing and breath-holding, plus the wearing of a weightlifting belt, may also contribute to these unhelpful downward pressures.
Olympic weightlifting can be classified by two movements shown in the linked videos – the snatch:
And the clean and jerk:
In one study, 32% of experienced female weightlifters leaked during the snatch and the clean and jerk! (It was also interesting to note that 57% leaked during multiple repeats of a conventional weighted squat!). So if you leak while you lift, you are definitely not alone!
The females in this study discussed some of the strategies they used to manage leakage. These included performing pelvic floor exercises, focusing on activating their core and pelvic floor during lifts, wearing dark clothing, and wearing incontinence pads. Some even admitted to dehydrating themselves prior to lifting, which of course could reduce their urine output and potentially pose a safety concern.
Have you had your pelvic floor checked?
One of the discussion points made by the researchers was that 75.7% of women with leaking had not had a pelvic floor examination, and 22.9% of the exercising women were not confident in their ability to perform pelvic floor exercises properly. Our pelvic health therapists often see women who are very strong on the outside, but not so strong on the inside!
Having a well-functioning pelvic floor can be of great benefit to any athlete when lifting a heavy weight in training or competition. We think that your performance will improve if you can devote 100% of your concentration to lifting, rather than managing or worrying about leakage. Allowing you to train harder, and compete harder!
We believe that the rates of leakage would decrease, and participation rates would increase, if women who want to lift were given the opportunity to identify and work on pelvic floor strength.
We would love to see more weightlifting women stay with their chosen sport, for all the physical and mental health benefits that it brings.
Of course, for some women, lifting a washing basket or a child, or even just with coughing or laughing can be enough force to provoke leakage.
If urine leakage is affecting you, one of our Pelvic Health Physiotherapists can help you with a pelvic floor strengthening program or a vaginal support pessary fitting (see separate blog article) to help you function at your best!
To get the right support and guidance in strengthening your pelvic muscles and avoid urine incontinence when lifting, you may contact our pelvic floor physiotherapists here to get started.
1. Brennand E, Ruiz-Mirazo E, Tang S, Kim-Fine S. Calgary Women’s Pelvic Health Research G. Urinary leakage during exercise: Problematic activities, Adaptive Behaviours, and interest in treatment for physically active Canadian women. Int Urogynecol J 29: 497–503, 2018.
2. Wikander, L., Kirshbaum, M.N., Waheed, N. and Gahreman, D.E., 2022. Urinary incontinence in competitive women weightlifters. The Journal of Strength & Conditioning Research, 36(11), pp.3130-3135.